Contact Information

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You will be contacted within two business days by our Recruiting Officer.

Current College/University (Leave blank if none):

Current Major and Projected Graduation Date (Leave blank if none):

Military Experience (Check all that apply)
JROTC: SROTC: Active Duty: National Guard: Reserve: Other:

Personal Information
NMSU ID # (if you have being accepted to this university)
Birth Date:

Height (inches): Weight (pounds):
Marriage Status: Single/Divorced Married Children: No Yes

Medical Conditions (Check any that apply)
Asthma: ADD/ADHD: Bipolar: Orthopedic Injury: Eye Surgery:
Pins/Screws/Plates: Other:
If Any, Please Explain:

Criminal History (Check All That Apply)
Domestic Violence: Drug Use: DUI/DWI: Probation:
Other Felonies: Restraining Orders:
Fine Over $250: Other:
If Any, Please Explain:

Academic Information
High School GPA: SAT/ACT: College GPA:
Honor Societies:

Athletic Information
HS Varsity Letter: Individual Sport:
College Team: College Intramurals:

Leadership Activities
Eagle Scout: Team Captain:
Club Leader: Volunteer Leader:

Other Leader:

Commissioning Preference:

Active Army , National Guard , Reserves

Other Comments  

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